Download Free Medical Hodgkins Lymphoma PowerPoint Presentation

Hodgkins Lymphoma PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Hodgkins Lymphoma

Tags : Hodgkins Lymphoma

Published on : Aug 15, 2023 | Views : 2964 | Downloads : 17

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Prepared and Presented by: Dr. Nirav S. Panchal Assistant Professor, Dept. of Pathology, GMERS Medical College, Vadnagar. HODGKIN’S LYMPHOMA & NON- HODGKIN’S LYMPHOMA
Slide 2-

Leukemia Vs. Lymphoma Leukemia is used for lymphoid neoplasm presenting with widespread involvement of the bone marrow, accompanied by presence of tumor cells in peripheral blood. Lymphoma is used to describe proliferations arising as discrete tissue masses. It is malignant tumor of lymphoreticular origin (from lymphocyte)
Slide 3-

Lymphoma Hodgkin’s lymphoma/Disease Non hodgkin’s lymphoma Plasma cell neoplasms
Slide 4-

WHO Classification of Lymphoid Neoplasms As per WHO classification all lymphoid neoplasms fall into following 5 categories: I. Hodgkin’s disease II. Precursor (Immature) B-cell malignancies III. Peripheral (Mature) B-cell malignancies IV. Precursor (Immature) T-cell malignancies V. Peripheral (Mature) T-cell and NK–cell malignancies
Slide 5-

WHO Classification of Lymphoid Neoplasms Non – Hodgkin’s Lymphoma
Slide 6-

WHO Classification of Lymphoid Neoplasms Non – Hodgkin’s Lymphoma
Slide 7-

WHO Classification of Lymphoid Neoplasms B. Hodgkin’s Lymphoma Classic Nodular sclerosis Lymphocytic rich Mixed cellularity Lymphocytic depletion Nodular lymphocytic predominant
Slide 8-

Hodgkin’s Lymphoma Definition “Hodgkin lymphoma" (HL), encompasses a group of lymphoid neoplasms that: arise in a single node or chain of nodes spread first to the anatomically contiguous nodes are characterized morphologically by the presence of neoplastic giant cells called Reed- Sternberg (RS) cells or it’s variants
Slide 9-

whose predominant component is comprised of non-neoplastic inflammatory cells (reactive lymphocytes, plasma cells, histiocytes, eosinophils and neutrophils).
Slide 10-

Hodgkin’s Lymphoma Incidence HL comprise 20-30% of all malignant lymphomas and 8% of all cases of lymphoid neoplasms. The incidence of the disease has bimodal peaks— one in young adults between the age of 15 and 35 years and the other peak after 5th decade of life. The HD is more prevalent in young adult males than females.
Slide 11-

Hodgkin’s Lymphoma Classification Rye’s classification WHO Central to the diagnosis of HD is the essential identification of Reed-Sternberg cell.
Slide 12-

WHO Classification
Slide 13-

Hodgkin’s Lymphoma Etiopathogenesis EBV Genetic factors: certain HLA B18 types, identical twins Cytokines: IL-5, IL-13, TGF - β
Slide 14-

ppt slide no 14 content not found
Slide 15-

Reed – Sternberg Cells It is neoplastic giant cell. Hallmark of HD is presence of RS cell. It comprises only 1-5% of total tumor mass. It is derived from germinal centre or post germinal centre B cell. It induces the accumulation of reactive lymphocytes, histiocytes & tissue eosinophils.
Slide 16-

Reed – Sternberg Cells Characteristics Giant cell with a bi-lobed nucleus as if mirror image of each other. Each lobe of the nucleus contains a prominent, eosinophilic, inclusion like nucleolus with a clear halo around it, giving an owl-eye appearance. The cytoplasm of cell is abundant and amphophilic.
Slide 17-

RS Cell – Histological variants
Slide 18-

RS Cell – Histological variants
Slide 19-

RS Cell – Histological variants
Slide 20-

RS Cell – Histological variants
Slide 21-

RS Cell – Histological variants
Slide 22-

Hodgkin’s Disease subtypes A. Nodular Sclerosing Incidence: most common form of HL, constituting 65% to 70% of cases Clinical features: affect adolescents or young adults males and females are affected equally has propensity to involve the lower cervical or supraclavicular, with mediastinal lymph nodes most present in stage I/II
Slide 23-

Hodgkin’s Disease subtypes - Nodular Sclerosing Morphology: there is diffuse effacement of the nodal architecture by collagen bands dividing lymphoid tissue into circumscribed nodules. shows “lacunar variant” of the RS-cells. Classic RS-cells are less frequent. non-neoplastic inflammatory component is comprised of small lymphocytes, eosinophils, plasma cells, and macrophages. large geographic areas of necrosis are often seen. RS cells may also show necrosis, presence of mummified variant. IHC: CD45-, CD5-, CD20-, CD15+, CD30+, EBV Prognosis: excellent
Slide 24-

Hodgkin’s Disease subtypes - Nodular Sclerosing
Slide 25-

Hodgkin’s Disease subtypes - Nodular Sclerosing
Slide 26-

Hodgkin’s Disease subtypes – Mixed Cellularity B. Mixed Cellularity Incidence constitute about 20% to 25% of cases Clinical manifestations biphasic incidence, peaking in young adults and again in adults older than 55 years more common in males Sub-diaphragmatic disease is more common patients generally present in advanced tumor stage III/IV
Slide 27-

Hodgkin’s Disease subtypes – Mixed Cellularity Morphology: characterized by diffuse effacement of lymph node architecture by a heterogeneous cellular infiltrate of small lymphocytes, eosinophils, plasma cells, and macrophages admixed among them are plentiful number of classic RS-cells and their mononuclear variant. IHC: CD45-, CD5-, CD20-, CD15+, CD30+, 70% EBV+ Prognosis: not as favourable as “Nodular-Sclerosing” and “Lymphocyte-Predominant”
Slide 28-

Hodgkin’s Disease subtypes – Mixed Cellularity
Slide 29-

Hodgkin’s Disease subtypes – Mixed Cellularity
Slide 30-

Hodgkin’s Disease subtypes - Lymphocyte – Rich C. Lymphocyte – Rich Incidence: uncommon form of Classic HL Clinical features: Older adults (median age 43 years) M >F Presents in stage I/II Mediastinal involvement is common
Slide 31-

Hodgkin’s Disease subtypes - Lymphocyte – Rich Morphology: lymph nodes are diffusely effaced, but vague nodularity may be seen presence of frequent mononuclear and classic RS- cells monomorphic inflammatory infiltrate, comprised of reactive lymphocytes IHC: CD45-, CD5-, CD20-, CD15+, CD30+, 40% EBV+ Prognosis: very good to excellent
Slide 32-

Hodgkin’s Disease subtypes - Lymphocyte – Rich
Slide 33-

Hodgkin’s Disease subtypes - Lymphocyte – Depleted D. Lymphocyte – Depleted Incidence: Least common form of HL, amounting to < 5% of cases. Clinical features: Older patients More commonly seen in HIV-positive individuals peripheral lymphadenopathy is common in “Reticular form” and BM involvement in “diffuse fibrosis type” Sub diaphragmatic disease or organomegaly is common presents in advanced stage
Slide 34-

Hodgkin’s Disease subtypes - Lymphocyte – Depleted Morphology: Characterized by paucity of lymphocytes and a relative abundance of pleomorphic variants of RS-cells IHC: CD45-, CD5-, CD20-, CD15+, CD30+, most EBV+ Prognosis: overall outcome is somewhat less favourable than other subtypes
Slide 35-

Hodgkin’s Disease subtypes - Lymphocyte – Depleted
Slide 36-

Hodgkin’s Disease subtypes – Nodular Lymphocyte – Predominance Incidence: uncommon variant, accounting for approximately 5% of all cases Clinical features: majority of patients are males usually younger than 35 years of age present with cervical or axillary lymphadenopathy mediastinal and bone marrow involvement is rare
Slide 37-

Hodgkin’s Disease subtypes – Nodular Lymphocyte – Predominance Morphology: characterized by nodal effacement by expanded B-cell follicles follicles are comprised by small lymphocytes admixed with variable numbers of histiocytes lymphohistiocytic (L&H) variants ("popcorn cell"). IHC: CD20+, CD15-, CD30-, BCL6+, EBV Prognosis: excellent Recurrence is more likely than the classical subtypes 3% to 5% of cases transform to diffuse large B-cell lymphoma
Slide 38-

Hodgkin’s Disease – Clinical Features Hodgkin’s disease is particularly frequent among young and middle-aged adults. All histologic subtypes of HD, except the nodular sclerosis variety, are more common in males. The disease usually begins with superficial lymph node enlargement and subsequently spreads to other lymphoid and non-lymphoid structures.
Slide 39-

Hodgkin’s Disease – Clinical Features Painless lymphadenopathy Cervical/Mediastinal> Axillary, inguinal & abdominal Splenomegaly & Hepatomegaly Constitutional Symptoms/Type B symptoms: Night sweats Low grade fever Weight loss Fatigue, malaise, weakness, pruritus
Slide 40-

Hodgkin’s Disease – Laboratory Findings Hematological Anemia – Normocytic, Normochromic WBC – leukemoid reaction Advanced disease is associated with absolute lymphopenia. Platelets – normal or increased ESR – elevated Bone marrow – infiltration causing marrow failure: leucoerythroblastic reaction S. Iron and TIBC are decreased but marrow iron stores are normal or increased.
Slide 41-

Hodgkin’s Disease – Laboratory Findings Immunological: Defective cellular immunity Fall in T cell count reversal of CD4: CD8 ratio Humoral antibody production is normal in untreated patients until late in the disease.
Slide 42-

Hodgkin’s Disease – Staging
Slide 43-

Hodgkin’s Disease – Staging Investigations done for complete staging Documentation of B symptoms Physical examination Chest X-ray; CT abdomen & pelvis CBC,RFT, LFT B/L bone marrow biopsy; IHC for typing Lymphangiography of lower extremities Staging laprotomy biopsy of selected lymph nodes in the retroperitoneum spleenectomy wedge biopsy of the liver.
Slide 44-

Hodgkin’s Disease – Prognosis HD is now curable in most cases. Cure rate for stages I and IIA is close to 90%. Even with advanced disease (stages IVA and IVB), 60% to 70% 5-year disease-free survival is obtained. Mixed-Cellularity type and Lymphocyte-Depleted type are associated with less favourable prognosis.
Slide 45-

Long-term survivors of chemotherapy and radiotherapy have an increased risk of developing second cancers: 1. Myelodysplastic syndromes 2. AML 3. lung cancer 4. NHL 5. breast cancer 6. gastric cancer 7. sarcoma 8. malignant melanoma
Slide 46-

HL Vs. NHL
Slide 47-

THANK YOU KEEP READING